Memo to the Supreme Court: Health Care Is Not a Right

One need only read the legal briefs or hear the oral arguments made before the U.S. Supreme Court last week on the constitutionality of just one provision in the 2700-page ObamaCare law (the mandate to buy health insurance) to recognize that both sides blithely assume that “health care is a right.” The law itself and many of the Justices also assume it. Thus most everyone in this alleged “debate” is merely quibbling over how much the rights of health care providers will be violated – for that’s what a mythical “right to health care” entails.

In fact, health care is not a right. It’s a valuable service provided by intelligent, hard-working professionals with years of painstaking education and training, people who, like other Americans, deserve equal protection under the law, people who, like other Americans, have a right to their own life, liberty, property and the pursuit of their own happiness. Doctors, nurses, hospitals, drug-makers, and health insurers are no more “servants” of the masses, or even of those in need of health care, than are businessmen, bankers, teachers, journalists, or truck drivers servants of those who need their services. If you want to pay for the services of health care providers, simply do so; if you can’t afford it, try to negotiate a discount, or pay by installments, or seek access to private charity; but you have no “right” to take from health care providers what they’re not willing to supply.

Notice how everyone claims to have “standing” in the ObamaCare case, a genuine interest or right at stake, yet nowhere found “standing” at court are the producers of health care – the doctors, nurses, hospitals, researchers, drug-makers, or health insurers. They are presumed to owe a “noble” and selfless duty (i.e., their time, talent, income and profits) to patients; they are not at liberty to work on their own terms, but only on those dictated by demagogic politicians, or decreed by power-lusting regulators, or demanded by needy patients. The producers are to be mere means to the ends of others. Consumers allegedly have a “right” to what health care providers provide, a “right” to say what will be provided, when, and at what price.

Note to sentient beings who might still be participating in the ObamaCare “debate:” this is a form of slavery.

Instead of political theorists and legal jurists rejecting out of hand the legitimacy of slavery – whether of health care providers or of those who are forced to purchase something – only the scope and degree of the slavery is being “debated” before America’s highest court, as if it’s a civilized question to begin with. Also, the debate arises under the supposedly sacrosanct tradition of “deliberative democracy,” meaning mob bull sessions (or see the placard-wielding screamers camped out on the steps of the Court). You see, if the majority mob today wishes to get something, they simply get to get it, even if in getting it they enslave others. That’s “democracy,” or what Winston Churchill labeled “the worst form of government, except for all the others,” but which is, in fact, the worst form of government period. Yes, people, the Germans voted for the Nazis.

Some or all of ObamaCare may be upheld or struck down when the Supreme Court renders its decision in June, but regardless, notice how no one has bothered to rebut the claim that health care is a “right.” As such, there will likely be no sound remedy in the Court's decision; providers’ rights will still be violated. But observe: the rights of health care providers have already been broadly and routinely violated for nearly five decades now – since at least the mid-1960s – also with no legal redress. It happened because government gradually took over much of the health care sector. In 1960 less than 5% of health care spending in the U.S. came from government; today more than 50% of it does so. With such funding always come “strings attached;” in this case, strings have been weaved into a noose around the necks of health care providers.

It is revealing that almost no one complained about these ever-tightening nooses around the necks of health care producers – least of all the appeasing producers themselves – yet now there’s much gnashing of teeth among consumers of health care who only now are realizing that they too will be forced to suffer the consequences of socialized medicine, that they too will suffer mandates, that they too will face the faceless Washington bureaucrats intent on ignoring them as they suffer and die in lines waiting for rationed care, as occurs routinely in Britain or Canada. Only now are the so easily-deluded masses realizing that as consumers they depend on producers, that if, as consumers, they encourage, vote for and condone the enslavement and impoverishment of the producers, there will be nothing left for them to purchase, at any price. Welcome to the real world, to the world of rational self interest and the Law of Supply and Demand; you can hate these principles of robust life, if you wish, Almighty Consumers, but they (and reality) cannot be conned, not even by the confidence men who tell you “ health care is a right,” even as doctors go on strike.

Recent complaints about excessive and exorbitant health care costs invariably fail to acknowledge that the problem itself derives from the false and immoral claim that “health care is a right,” for that’s what animated the push for Medicare and Medicaid back in the mid-1960s. Only after those schemes took hold did the costs of health care and health insurance race ahead of general U.S. price inflation. As mentioned, in 1960 less than 5% of health care spending in the U.S. came from government, but after decades of Medicare and Medicaid, combined with an aging population (a trend which private-sector insurance actuaries have easily and prudently handled, but politicians and HHS bureaucrats will not), that share has increased to more than 50% of all such spending. As in the case of college tuition and housing, so also in medical care: when government foots more and more of the bill, the bill grows more and more, and disproportionately so relative to other prices. When people then complain about higher costs, government boosts subsidies; in short, having caused the fire, it “cures” it with more gasoline; the arsonist plays the fireman who saves the day.

How much has U.S. government subsidization of health care disproportionately boosted its cost since Medicare and Medicaid were adopted in 1965 (and subsequently expanded)? In the three decades before 1965 (from which we get the oldest available price series for medical care), the cost of medical care in the U.S. increased by an average of 3.3% per year, while the broad CPI rate rose by an average of 3.0% per year. In the 1960s this miniscule differential (0.3% point), due mainly to higher quality health care, was used – along with the claim that “health care is a right” – to “justify” public subsidization of health care for the elderly and indigent. The result? In the three decades after 1965 the cost of medical care in the U.S. skyrocketed by 7.7% per year, while the broad CPI rate rose 5.5% per year. Quality improvements played some role in this, but quality also has declined in places, with less and less access to an increasingly socialized system; subsidies have played a huge role in the medical cost inflation seen since 1965; price increases only accelerated in the wake of Medicare and Medicaid, and they out-paced the CPI rate even more so than previously. Instead of scaling back these two culprits, Congress over the years only expanded them, to the point where it now piles on mandates and controls, allegedly to “cure” a systemic menace which was caused in the first place by its own subsidies and decrees.

Instead of treating the root cause of the ailment of out-sized health care inflation, health care “reformers” over the years have demanded still more subsidies and even broader coverage, which has only further inflated costs. In response, reformers demanded “cost containment” policies, like the HMO act (mid-1970s), or the price controls imposed according to DRGs (“diagnostic related groups”) in the 1980s. Every economist knows that inflation plus price controls cause shortages, but policymakers ignored the principle; in time a growing number of people had to go without health insurance coverage, and many started arriving at emergency rooms, as free loaders, demanding care. They too were said to have a “right” to health care, so in 1985 Congress enacted the Emergency Medical Treatment and Labor Act (EMTALA), which required hospitals to admit and treat arriving patients even if they couldn’t pay. Instead of requiring these free-loaders to pay their way, ObamaCare mandates that everyone else pay the tab, and surrender their health care freedom in the process.

Many other atrocities are embedded in the ObamaCare law beyond the mandate to buy health insurance. There are mandates that health care providers not charge ‘too much,” or make “too much” money, plus mandates that they charge loss-making prices, and decrees that insurers accept applicants with pre-existing medical conditions, or charge them no more than anyone else, plus mandates that they insure “children” up to age 26 as part of their parents’ health insurance plans. Those who are challenging ObamaCare before the Supreme Court don’t seem to care a bit about the mandates imposed on producers; they’re bothered only by the mandate imposed on consumers. The right-wing lawyers and Attorneys General claim to be stout defenders of the U.S. Constitution, but they’re sure selective about it; they assume that there’s some inherent conflict between the producers and users of health care, that not all parties to trade in the sector deserve equal protections under the law, because, at root, they share the belief of ObamaCare’s left-wing defenders that health care is a “right,” thus that suppliers have no rights, but only a duty to serve, as serfs.